Association of subclinical inflammation, glycated hemoglobin and risk for obstructive sleep apnea syndrome

• Main Authors: Carolina Vicaria Rodrigues D’Aurea, Bruno Gion de Andrade Cerazi, Antonio Gabriele Laurinavicius, Carolina Castro Porto Silva Janovsky, Raquel Dilguerian de Oliveira Conceição, Raul D Santos, Márcio Sommer Bittencourt
• Format: Article
• Language: English
• Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein
• Series: Einstein (São Paulo)
• Subjects: Apneia obstrutiva do sono; Hemoglobina A glicosilada; Doenças cardiovasculares; Inflamação
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082017000200136&lng=en&tlng=en

ABSTRACT Objective To investigate the inter-relation between high sensitivity C-reactive protein and glycated hemoglobin in prediction of risk of obstructive sleep apnea. Methods We included all individuals participating in a check-up program at the Preventive Medicine Center of Hospital Israelita Albert Einstein in 2014. The Berlin questionnaire for risk of obstructive sleep apnea was used, and the high sensitivity C-reactive protein and glycated hemoglobin levels were evaluated. Results The sample included 7,115 participants (age 43.4±9.6 years, 24.4% women). The Berlin questionnaire showed changes in 434 (6.1%) individuals. This finding was associated with high sensitivity C-reactive protein and glycated hemoglobin levels (p<0.001). However, only the association between the Berlin questionnaire result and glycated hemoglobin remained significant in the adjusted multivariate analysis, for the traditional risk factors and for an additional model, including high-density lipoprotein cholesterol and triglycerides. Conclusion The glycated hemoglobin, even below the threshold for diagnosis of diabetes, is independently associated with obstructive sleep apnea syndrome, even after adjustment for obesity and C-reactive protein. These findings suggest a possible pathophysiological link between changes in insulin resistance and obstructive sleep apnea syndrome, independently from obesity or low-grade inflammation.